March 2026
The United States counted 771,480 people experiencing homelessness on a single night in January 2025. This number has been rising for most of the past decade, despite steadily increasing federal spending on homeless services. If you proposed a business model where a decade of growing investment produced a larger version of the problem the investment was supposed to solve, no one would fund you. The federal government funded it.
Let me explain why this is more interesting than it sounds.
The story of homeless services is overwhelmingly a story of failure. Most approaches either don't work, work too modestly to matter at scale, or work in a pilot and disintegrate upon contact with a municipal bureaucracy. But embedded in this landscape are a handful of programs and approaches that produce outcomes so dramatically better than the baseline that they demand explanation. This essay is a survey of those successes — not because they solve homelessness, which is a structural condition produced by housing markets, mental health systems, drug policy, and wage stagnation, and no downstream intervention fully compensates for upstream failures — but because they reveal something important about which interventions survive contact with actual human behavior and which ones shatter on impact.
The pattern, once you see it, is almost embarrassingly simple.
I. The Structural Insight
For most of the twentieth century, homeless services in the United States operated on what the field calls the "staircase model" or "treatment first." The logic was intuitive: a person is homeless because they have problems — addiction, mental illness, criminal history, unemployment. Fix the problems, and the person can sustain housing. Therefore, require them to demonstrate progress on those problems before providing permanent housing. Sobriety first. Treatment compliance first. Employment readiness first. Then a key.
This sounds reasonable. It is a perfect example of a system designed by people who have never been homeless.
Consider the actual incentive structure. You are sleeping under a bridge. You have a substance use disorder. Someone tells you that if you complete a treatment program, maintain sobriety for six months, attend regular appointments, and demonstrate housing readiness, you will eventually receive an apartment. You are doing this while sleeping under a bridge. While managing an untreated mental health condition. While storing your belongings in a shopping cart. The cognitive load of maintaining sobriety under these conditions is roughly equivalent to asking someone to study for the bar exam during a house fire.
The staircase model had a dropout rate that should have been diagnostic. Depending on the program and population, anywhere from 50 to 80 percent of participants failed to "graduate" to permanent housing.1 The field's response to this failure rate was, for decades, to conclude that the clients were too damaged.
Not that the model was asking them to do the impossible.
Then, in the early 1990s, a clinical psychologist named Sam Tsemberis at an organization called Pathways to Housing in New York City did something the entire field considered irresponsible. He gave homeless people with severe mental illness apartments first, with no preconditions, and offered voluntary supportive services afterward.2
It worked.
II. Housing First: The Evidence
Housing First is now the most studied intervention in the homelessness field, supported by four major randomized controlled trials and dozens of observational studies. The evidence is not subtle.
The original Pathways to Housing studies in New York City, conducted between 2000 and 2004, found that 79 percent of Housing First participants remained stably housed at six months, compared to 27 percent in the city's traditional residential treatment program.3 After two years, 62 percent of Housing First participants had been housed the entire time, compared to 31 percent of those required to participate in treatment first.4
The Canadian At Home/Chez Soi trial — a $110 million, five-city randomized controlled trial, the largest of its kind ever conducted — found that Housing First participants spent 73 percent of their time in stable housing, compared to 32 percent for the treatment-as-usual group.5
A meta-analysis of the RCTs, published in the Journal of Epidemiology and Community Health, concluded that Housing First reduces emergency department visits, hospitalizations, and time spent hospitalized compared to treatment as usual, though variability between studies was considerable.6 A separate systematic review by the Community Preventive Services Task Force, drawing on 26 studies, found that Housing First decreases homelessness, increases housing stability, and improves quality of life.7
The cost picture is where the structural observation gets interesting. Every dollar invested in Housing First produces an average of $1.44 in cost savings to the broader system — emergency rooms, jails, psychiatric hospitalizations, sobering centers.8 For the ten percent of participants who had the highest costs prior to entering housing, every $10 invested in Housing First services produced an average savings of $21.72.9 The average cost savings to the public ranged from $900 to $29,400 per person per year after entry into a Housing First program, depending on the population and the city.10
Read that range again. Even at the low end, the program pays for a chunk of itself in avoided emergency costs. At the high end, it pays for itself twice over.
III. The Honest Limitation
Here is where the evidence becomes less comfortable for Housing First advocates, and where the structural analysis gets genuinely interesting.
Housing First clearly wins on housing stability. It clearly wins on cost. The evidence that it also fixes the underlying conditions — addiction, mental illness, chronic medical problems — is substantially weaker. The National Academies of Sciences conducted a comprehensive survey of all permanent supportive housing studies and found "no substantial published evidence as yet to demonstrate that PSH improves health outcomes."11
This is a significant finding that many advocates prefer to skip over.
One randomized controlled trial in Ottawa found that homeless people placed in permanent supportive housing actually had higher rates of substance use than people left in the usual-services group.12 A PBS documentary tracked residents of supportive housing and found that for some people with severe mental illness, a permanent apartment increased social isolation.13 Critics from the Cicero Institute have argued that since the federal government mandated Housing First nationwide in 2013, street homelessness has increased by nearly a fourth, and that cities like San Francisco and Phoenix built enough permanent housing to shelter every chronically homeless person and saw homelessness rise anyway.14
Some of these criticisms land. Some don't.
The San Francisco and Phoenix arguments confuse stock with flow. A city can build enough housing to shelter everyone counted as homeless in a given year, but if new people become homeless faster than existing people are housed — because rents rise, because fentanyl reshapes the addiction landscape, because psychiatric beds disappear — the count goes up regardless of the housing supply. Blaming Housing First for rising homelessness is like blaming umbrellas for rain because you see more of them during storms.
The criticism that Housing First "attracts" people into the homelessness system has some empirical support — one economic analysis estimated that cities must build roughly 10 permanent supportive housing beds to remove a single homeless person from the street, because most units go to people who would not have been permanently homeless otherwise.15 But this is a targeting problem, not a model problem.
The more serious critique is the one about self-destruction. You can give someone an apartment. If they are determined to drink themselves to death in it, the apartment does not prevent this. If severe untreated psychosis makes it impossible for them to maintain basic tenancy — paying the subsidized rent, not destroying the unit, not creating safety hazards for neighbors — then the apartment becomes a temporary waystation rather than a solution. Roughly 10 to 20 percent of Housing First participants lose their housing within two years, and the reasons are not mysterious.16
The honest structural observation is this: Housing First does not fix self-destructive people. What it does is stop requiring self-destructive people to fix themselves as a precondition for not sleeping outside. Some of them then improve, because stability turns out to be a prerequisite for recovery rather than a reward for it. Some of them don't improve but cost the public dramatically less. And some of them leave.
Whether "some people won't be saved" is a reason to reject an intervention that works for most is a philosophical question, not an empirical one. The empirical question has been answered.
IV. The Case Studies That Worked
Finland. The most complete national success story. In 2007, Finland's Housing Minister convened a working group that produced a report titled "Name on the Door," recommending a shift from the staircase model to Housing First. The government implemented the recommendation in 2008. Between 2008 and 2022, the number of individuals experiencing long-term homelessness in Finland decreased by 68 percent.17 Total homelessness fell from over 18,000 in 1987 to fewer than 3,806 in 2024 — about 0.06 percent of the Finnish population, compared to roughly 0.2 percent in the United States.18
The Finnish model differs from the American version in important ways. Finland treats Housing First as a systemic national policy, not a program bolted onto an existing patchwork. The government spent over €270 million between 2008 and 2019 converting emergency shelters into permanent housing units.19 Helsinki's shelter beds dropped from 2,121 in 1985 to 52 in 2016, while supportive housing units grew from 127 to 1,309 and independent rental apartments for formerly homeless people increased from 65 to 2,433.20 The Y-Foundation, a nonprofit that serves as Finland's fourth-largest landlord, buys properties with discounted government loans and rents them to people coming out of homelessness. Some of the property acquisition funding comes from the Finnish national lottery.21
Finland also has structural advantages that make comparison tricky. It is a small, wealthy, ethnically homogeneous Nordic country with a strong social safety net, a constitutional right to housing, and a climate that makes sleeping outdoors fatal for significant portions of the year. It has 5.5 million people. The Houston metropolitan area has seven million. But the comparison still teaches something: when a country commits to Housing First as a national policy rather than a competitive grant program, and backs it with actual housing stock rather than vouchers that landlords refuse to accept, the numbers move.
Four out of five people housed through the Finnish program did not return to homelessness.22
Houston. The most impressive American case. In 2011, Houston had the sixth-largest homeless population in the country, with about 8,500 people counted on a given night. By 2022, that number had dropped by 63 percent, more than any other top-ten U.S. city.23 The region has housed over 37,000 people since 2012, with approximately 90 percent remaining housed for two or more years.24
Houston's model has three components worth isolating.
First, coordination. The city created a single umbrella organization called The Way Home, run by the Coalition for the Homeless, that aligned over 100 nonprofit service providers, city and county government, public housing authorities, and philanthropic organizations under a shared data system and shared goals.25 Before this, dozens of organizations were all trying to do everything independently — competing for funding, duplicating services, and producing a system where the left hand had no idea the right hand existed. The coordination alone was probably worth more than any individual program.
Second, the housing model itself. Houston provides an actual apartment with a lease in the person's name, a rent subsidy, and wraparound support services — case management, mental health treatment, employment assistance — that are available but not mandatory.26 The cost is roughly $18,000 per person per year. Leaving people on the streets costs an estimated $30,000 to $50,000 per person per year in emergency services, depending on whose numbers you use.27
Third, Houston has structural advantages other cities lack, and it is important to name them honestly. Rents are lower than in coastal cities. The city's famous absence of zoning eliminates one of the most common NIMBY objection points. Texas spends very little state money on homelessness — $806 per unhoused person versus California's $10,786 — which means Houston accomplished its results with almost laughably limited resources, primarily federal HUD funding.28 This is arguably the most impressive part: the model works even when it's cheap.
The model is now under pressure. Federal pandemic-era funding is expiring. The Coalition for the Homeless estimated that without at least $50 million per year in new funding, approximately 5,200 people who had been housed could become homeless again by the end of 2026.29 The political leadership has also shifted, with the current mayor pursuing a more enforcement-oriented approach alongside the housing strategy.30
Success, in homeless services, turns out to be something you have to keep paying for. Stop paying and the success evaporates. This is not a design flaw in the program. It is a description of what housing costs.
V. Veterans: The Scaled Success
If you want to know what happens when the United States actually commits resources to a homeless population at scale, look at veterans.
Veteran homelessness has declined 55.6 percent since 2010, reaching a record low of 32,882 on a single night in January 2024.31 In 2023, the VA permanently housed 46,552 veterans, exceeding its annual goal by 22.5 percent. Of veterans housed in 2022, 95.9 percent remained in housing one year later.32
The primary vehicle is the HUD-VASH program — a collaboration between the Department of Housing and Urban Development and the Department of Veterans Affairs that combines Housing Choice Vouchers with VA case management and clinical services. The program was initially funded in 1992 with a modest pool of about 1,700 vouchers. In 2008, Congress significantly expanded it with $75 million for 10,000 new vouchers, followed by another 10,000 the next year. By late 2023, nearly 112,000 vouchers had been allocated nationwide.33
The results track the investment. A peer-reviewed study in the American Journal of Public Health found that for each additional HUD-VASH voucher awarded to a local area, the sheltered homeless count fell by 0.49 and the unsheltered count fell by 0.59. The researchers estimated that 45 percent of the total reduction in veteran homelessness was directly attributable to the voucher program.34
New York City provides the sharpest example. From 2011 to 2022, the city reduced its total homeless veteran count by 90 percent — from 4,677 to 482 individuals.35
Ninety percent.
The veteran story teaches a specific structural lesson. The VA operates an integrated healthcare system — a single entity that provides medical care, mental health treatment, substance abuse services, and now housing support under one institutional roof. For non-veteran homeless populations, the equivalent services are scattered across disconnected agencies, each with its own eligibility requirements, waiting lists, and data systems. A homeless veteran sees a VA caseworker who can access their medical records, their service history, their benefits eligibility, and their housing voucher status from one desk. A homeless non-veteran navigates between county mental health, Medicaid, a housing authority, and a nonprofit — four separate bureaucracies that may or may not share information with each other.
The program works in part because the institution is structured to deliver it. For the general homeless population, the institution does not exist.
Dennis Culhane, a professor at the University of Pennsylvania who studies homelessness policy, has pointed out the disparity in scale: we have more housing vouchers available for chronically homeless veterans than there are chronically homeless veterans to fill them. For the non-veteran population, only about 9 to 10 percent of people experiencing homelessness access either rapid rehousing or supportive housing.36 One in ten. The veteran success does not reflect better methods. It reflects what happens when you actually fund the methods.
VI. The Smaller Wins
Critical Time Intervention. CTI is a time-limited case management model — nine months — designed to prevent homelessness during transitions out of institutions: hospitals, prisons, shelters. The logic is that the first 30 to 90 days after leaving an institution represent the highest risk for falling into homelessness, and a focused intervention during that window can produce durable results that persist after the intervention ends.37
The first RCT, conducted with 96 homeless men with severe mental illness leaving a large New York City shelter, found that those assigned to CTI had only one-third the number of homeless nights as the comparison group over an 18-month follow-up. The effect persisted beyond the end of the nine-month intervention.38 A second RCT with 150 previously homeless men and women after discharge from psychiatric hospitals replicated the finding.39 A quasi-experimental study across eight VA medical centers found similar results — CTI participants had significantly more days housed than the comparison group over a one-year follow-up.40
CTI meets the Coalition for Evidence-Based Policy's "Top Tier" standard — well-designed RCTs showing sizable, sustained benefits, replicated in multiple sites.41 It is one of very few interventions specifically designed to prevent first-episode or recurrent homelessness, rather than treat existing homelessness. An economic analysis found that the CTI group and the usual-services group incurred nearly identical average costs for acute care — meaning the intervention paid for itself while producing better outcomes.42
The structural elegance of CTI is that it solves a specific, identifiable failure point: the gap between institutional care and community living, where support networks are weakest and risk is highest. Nine months. Focused. Then it ends, and the community supports it built are supposed to remain in place. This is the rare intervention that is both evidence-based and affordable enough to scale.
Rapid Rehousing. Rapid rehousing provides short-term rental assistance and case management to get people into permanent housing quickly, typically within 30 to 90 days. It targets a different population than permanent supportive housing — generally people experiencing homelessness who do not have severe, chronic disabilities, but who have experienced a financial crisis or temporary disruption.
The evidence is more modest than for permanent supportive housing, but encouraging. In HUD's Rapid Re-Housing for Homeless Families Demonstration, only 10 percent of served households returned to homeless shelters within the study period.43 Data from the VA's Supportive Services for Veteran Families program show that 93 percent of families and 88 percent of single adult veterans who were rapidly rehoused did not return to shelter for at least one year.44 The cost is dramatically lower than other interventions: an average of $6,578 per family, compared to $16,829 for emergency shelter, $18,821 for a permanent housing subsidy, and $32,557 for transitional housing. Five families can be rapidly rehoused for what it costs to put one family through transitional housing.45
The limitation: the effects may not be permanent. One study of the federal Homelessness Prevention and Rapid Re-Housing Program found that the reductions in homelessness faded after program funding ended.46 This makes sense. If the underlying cause of someone's homelessness is that they can't afford rent, and you pay their rent for three months, and then their income hasn't changed, the math hasn't changed either. Rapid rehousing works as a bridge. It does not work as a destination for people whose incomes will never cover market rents.
1811 Eastlake. This is the single program most worth knowing about, because it is both the most successful and the most offensive to conventional moral intuitions.
1811 Eastlake is a 75-unit supportive housing building in Seattle, opened in 2005, that specifically targets chronically homeless adults with severe alcohol use disorders — the population that had failed, on average, 16 prior treatment episodes.47 Residents are allowed to drink in their rooms. There is no sobriety requirement. There is no treatment mandate. There are on-site support services available 24 hours a day, which residents may use or ignore.
A 2009 study published in the Journal of the American Medical Association found that the program saved taxpayers more than $4 million in its first year of operation. The average cost per person while homeless — emergency rooms, jail, the sobering center, EMS — was $86,062 per year. The cost to house and serve them at 1811 Eastlake was approximately $13,440 per year.48
The savings came from a collapse in crisis service usage. Monthly costs for alcohol-related hospital emergency services, the sobering center, and jail dropped from $4,832 per person while homeless to $1,492 per person six months after moving in.49
And then there was the finding that nobody expected. Residents decreased their drinking by roughly 25 to 33 percent after moving in.50 Not because anyone told them to. The researchers theorized that when you are homeless and you have alcohol, you drink all of it immediately, because it will be stolen or confiscated. When you have a room with a lock on the door, this particular incentive to binge disappears. The drinking didn't stop, but it moderated, driven by the logic of having a door to close.
A subsequent study in Addictive Behaviors found that residents' internal motivation to change was more predictive of decreased drinking than attendance at treatment programs.51 The implication is straightforward: people change when they are ready, and they are more likely to become ready when they are not in survival mode. You cannot will yourself into recovery while your primary cognitive task is figuring out where to sleep tonight.
Harborview Medical Center, the hospital that had previously absorbed most of the emergency costs from these same individuals, was so persuaded by the savings that it loaned a full-time advanced registered nurse practitioner to the building to prevent medical emergencies before they started.52 A hospital paying for preventive care to keep its own emergency room empty. The incentives, for once, aligned.
VII. The Pattern
Every program surveyed here shares a structural logic, and the logic is simple enough to state in one sentence: stop conditioning stability on the prior achievement of stability.
Housing First gives people housing before they fix their lives. Critical Time Intervention provides intensive support during the specific window when people are most vulnerable, rather than distributing support evenly across time when most of it is wasted. Rapid rehousing gets people into apartments quickly rather than parking them in shelters while they wait for a slot in a program. 1811 Eastlake gives chronic alcoholics a room and a lock and discovers that the room and the lock do more therapeutic work than 16 prior treatment episodes managed.
The pattern is: meet people where they are. The corollary is: most of the history of homeless services has been an attempt to move people to where we think they should be before we help them.
There is also a less optimistic pattern. Every success story described above faces the same threat: funding. Houston's progress required sustained federal funding that is now expiring. Finland's model costs €270 million over a decade and requires ongoing government commitment that a new coalition government is already eroding. The VA's veteran homelessness success depends on a $3.2 billion annual budget. These programs work when they are paid for. They stop working when they are not. This is not a particularly profound observation, but it is the one that policy discussions most consistently fail to internalize. We keep looking for the clever intervention, the innovative model, the scalable pilot. The evidence suggests the intervention is obvious. The obstacle is that it costs money every year, forever, because housing costs money every year, forever.
One final observation, and then I'll stop.
The programs that work share one more trait: they are designed around how people actually behave, not how we wish they would. Treatment First was designed for people who would progress neatly through recovery milestones on their way to independence. Those people exist, but they are not the chronically homeless. The chronically homeless are the people for whom the staircase model was built and who fell off every stair. The programs that succeed are the ones that looked at the people who kept falling and concluded that maybe the problem was the stairs.
The evidence is clear enough. Whether we build the ramps is a question about budgets and political will, not about what works. We know what works. We have known for twenty years.
We just keep hoping something cheaper will come along.
Notes
1 The staircase or "treatment first" model is described in detail in the Community Preventive Services Task Force systematic review. See: Aidala, A. et al., "Permanent Supportive Housing with Housing First to Reduce Homelessness and Promote Health among Homeless Populations with Disability: A Community Guide Systematic Review," American Journal of Preventive Medicine, 2021. Available at: PMC. ↩
2 National Alliance to End Homelessness, "Housing First," March 2025. Link. ↩
3 National Low Income Housing Coalition, "The Case for Housing First," citing Pathways to Housing studies 2000–2004. Available at: NLIHC (PDF). ↩
4 Ibid. The Pathways studies found 62% of Housing First participants housed continuously at two years vs. 31% of the treatment-first group. ↩
5 Aubry, T. et al., At Home/Chez Soi trial results, cited in Tsai, J., "Is the Housing First Model Effective? Different Evidence for Different Outcomes," American Journal of Public Health, 2020; 110(9):1376. PMC. ↩
6 Baxter, A.J. et al., "Effects of Housing First Approaches on Health and Well-Being of Adults who are Homeless or at Risk of Homelessness: Systematic Review and Meta-Analysis of Randomised Controlled Trials," Journal of Epidemiology and Community Health, 2019; 73(5):379–387. ↩
7 Community Preventive Services Task Force recommendation, based on systematic review of 26 studies. Cited in NLIHC, "The Case for Housing First." NLIHC (PDF). ↩
8 NLIHC, "The Evidence Is Clear: Housing First Works," citing systematic review showing societal cost savings of $1.44 per dollar invested. NLIHC (PDF). ↩
9 At Home/Chez Soi economic analysis: every $10 invested in Housing First produced average savings of $21.72 for the 10% of participants with highest baseline costs. Cited in NLIHC, "The Case for Housing First." ↩
10 Cost savings range of $900–$29,400 per person per year, ibid. ↩
11 National Academies of Sciences, Engineering, and Medicine, Permanent Supportive Housing: Evaluating the Evidence for Improving Health Outcomes among People Experiencing Chronic Homelessness (Washington, DC: The National Academies Press, 2018). Cited in Cicero Institute, "Housing First is a Failure." Link. ↩
12 Ottawa RCT findings cited in Cicero Institute, ibid. ↩
13 PBS documentary on social isolation in supportive housing, cited in Cicero Institute, ibid. ↩
14 Cicero Institute, "Housing First is a Failure," July 2025. Link. ↩
15 Economic analysis on PSH beds vs. street removals, cited in Cicero Institute, ibid. ↩
16 Houston's Coalition for the Homeless reports ~90% housing retention at two years, implying ~10% attrition. Higher-need populations show higher attrition in multiple studies. ↩
17 Pathfinders, "Housing First Policy: Finland," April 2024. Link. ↩
18 Good Good Good, "How Finland lowered homelessness by 75%," April 2025, citing 3,806 citizens experiencing homelessness in Finland vs. 771,480 in the U.S. Link. ↩
19 Pathfinders, ibid. €270 million spent between 2008 and 2019, costs shared between central government and municipalities. ↩
20 Shinn, M. and Khadduri, J., "How Finland Ended Homelessness," Cityscape, 2020; 22(2). HUD User (PDF). Y-Foundation data on shelter bed and housing unit changes in Helsinki. ↩
21 Pathfinders, ibid. Lottery funding for property acquisition. ↩
22 The Better News, "Finland ends homelessness and provides shelter for all in need," updated February 2024. "4 out of 5 people affected thus make their way back into a stable life." Link. ↩
23 Smart Cities Dive, "How Houston's homeless strategy became a model for other US cities," November 2022. Link. ↩
24 Houston Public Media, "Mayor Whitmire wants to 'end homelessness' in Houston this year," February 2026. 37,000 people housed since 2011. Link. ↩
25 CBS News, "Inside Houston's successful strategy to reduce homelessness," November 2024. Link. ↩
26 Eichenbaum, M. and Nichols, M., "How Houston's homelessness breakthrough could be a national game-changer," CNN Opinion, June 2023. Link. ↩
27 Governing, "How Houston Cut Its Homeless Population by Nearly Two-Thirds," August 2023. $18,000/year per person housed; leaving people on the streets costs three to four times as much. Link. ↩
28 Ibid. Texas spends $806 per unhoused person vs. California's $10,786. ↩
29 Kinder Institute for Urban Research, Rice University, "Why Houston's progress on homelessness is in jeopardy," 2024. Link. ↩
30 Houston Public Media, ibid. Expansion of civility ordinance and enforcement-oriented approach under Mayor Whitmire. ↩
31 VA News, "Veteran homelessness reaches record low, decreasing by 7.5% since 2023," January 2025. Link. ↩
32 Ibid. 46,552 veterans housed in 2023; 95.9% retention rate for 2022 cohort. ↩
33 LifeSTEPS, "Veterans Affairs Supportive Housing 101," August 2025. Nearly 112,000 vouchers allocated as of December 2023. Link. See also Urban Institute, "Targeting Chronically Homeless Veterans with HUD-VASH." PDF. ↩
34 Evans, W.N. et al., "Housing and Urban Development–Veterans Affairs Supportive Housing Vouchers and Veterans' Homelessness, 2007–2017," American Journal of Public Health, 2019. PMC. ↩
35 New York State Comptroller, "Reduction in Homelessness Among New York's Veterans," 2023. PDF. ↩
36 Culhane, D., cited in Homeless Hub, "Preventing Homelessness in the United States: Evidence, Scaling, and What Works," June 2025. Link. ↩
37 Herman, D. et al., "Randomized Trial of Critical Time Intervention to Prevent Homelessness in Persons with Severe Mental Illness Following Institutional Discharge," Archives of General Psychiatry, 2011. PMC. ↩
38 Susser, E. et al., "Preventing Recurrent Homelessness among Mentally Ill Men: A 'Critical Time' Intervention after Discharge from a Shelter," American Journal of Public Health, 1997; 87(2):256–262. Summarized at Critical Time Intervention. ↩
39 Herman et al. 2011, ibid. Second RCT with 150 participants after psychiatric hospital discharge. ↩
40 Kasprow, W.J. and Rosenheck, R.A., "Outcomes of Critical Time Intervention Case Management of Homeless Veterans after Psychiatric Hospitalization," Psychiatric Services, 2007; 58(7):929–935. ↩
41 Evidence Based Programs, "Critical Time Intervention." Link. ↩
42 Jones, K. et al., "Cost-Effectiveness of Critical Time Intervention to Reduce Homelessness Among Persons With Mental Illness," Psychiatric Services, June 2003; 54(6):884–890. Summarized at CTI Handout (PDF). ↩
43 HUD, "Evaluation of the Rapid Re-housing for Homeless Families Demonstration (RRHD) Program." HUD User. Only 10% of served households returned to shelter. ↩
44 National Alliance to End Homelessness, "Rapid Re-Housing: A History and Core Components," October 2024. Link. SSVF data: 93% of families and 88% of single veterans did not return to shelter for at least one year. ↩
45 Ibid. Comparative per-family costs: $6,578 for rapid rehousing, $16,829 for emergency shelter, $32,557 for transitional housing. ↩
46 NLIHC, "Study Examines Effectiveness of Homeless Prevention and Rapid Re-Housing Program." Link. HPRP effects faded after program conclusion. ↩
47 DESC, "1811 Eastlake." Link. 75 units for formerly homeless adults with chronic alcohol use disorders. ↩
48 Larimer, M. et al., "Health Care and Public Service Use and Costs Before and After Provision of Housing for Chronically Homeless Persons with Severe Alcohol Problems," JAMA, 2009; 301(13):1349–1357. Summary available at: DESC (PDF). $86,062 annual cost while homeless vs. $13,440 housed. ↩
49 Ibid. Monthly crisis service costs dropped from $4,832 to $1,492 per person at six months. See also The Seattle Times, "Study: Housing homeless, letting them drink saves $4M a year," April 2009. Link. ↩
50 Collins, S. et al., study published in American Journal of Public Health, 2012. Summarized at NPR, "A Permanent Home That Allows Drinking Helps Homeless Drink Less," January 2012. Link. ↩
51 Study published in Addictive Behaviors, summarized at DESC, "1811 Eastlake." Internal motivation to change was more predictive of improved alcohol outcomes than treatment attendance. Link. ↩
52 Pacific Standard, "The Case for Allowing the Homeless to Drink," December 2014. Link. ↩
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